The role of weight loss and acetazolamide in the treatment of idiopathic intracranial hypertension (pseudotumor cerebri)☆
Section snippets
Patients and methods
The records of 48 consecutive patients evaluated within the past 6 years with IIH were reviewed. Fifteen patients from this group met the following enrollment criteria:
- 1.
The initial neuro-ophthalmologic evaluation was performed within 10 days of diagnosis of IIH.
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Treatment for IIH was limited to weight loss and use of acetazolamide (500–1000 mg daily) during a minimum study period of 4 weeks and maximum of 24 weeks.
- 3.
Only one lumbar puncture was performed, primarily as an aid in diagnosing IIH.
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Results
Table 1 provides a summary of patient data. All 15 patients were women with a mean age (±standard deviation) of 31.3 ± 8.8 years, ranging from 19 to 48 years. The mean weight was 110.5 ± 28.7 kg, ranging from 79.6 to 208.6 kg. The mean body mass index, calculated by dividing the weight in kilograms by the square of the height in meters, was 40.7 ± 13.0 kg/m2, ranging from 29.6 to 86.9 kg/m2. All patients were obese as defined by body mass index greater than 26 kg/m2.12 There was 100%
Discussion
The study documented the beneficial effect of weight loss in the treatment of IIH. Eleven (73.3%) of 15 patients had improved papilledema within the 24-week study period. Indeed, 10 (66.7%) of the 15 patients had complete resolution of papilledema within a median time of 8.5 weeks. The visual function similarly improved or remained normal in all patients with resolution of papilledema. The study identified that among the patients with a one-grade change in papilledema, a mean weight loss of
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Supported in part by an unrestricted grant from Research to Prevent Blindness, Inc., New York, New York, to the Mason Eye Institute of the University of Missouri-Columbia.